The Research Of Theory And Clinical By Collaterals Disease Theory Treating Chronic Nephrosis

Collateral disease theory is an important part of the traditional Chinese medicine. Inner Canon of Huangdi had firstly offered the concept of collaterals. It has discussed collaterals distribution,physiology and pathology. It has settled the foundation for collateral disease theory. Zhang Zhongjing developed collateral disease theory furtherly, He has expounded a part of collateral disease and pathogenesis,technique of diagnosis,prescription of some disease concerned with collaterals. In Qing Dynasty, the book of《Linzheng zhinanyian》introduced"protracted disease intruding into collateral","protracted pain intruding into collateral"definitely, emphasized that Initial disease"Qi"stagnated in"Jing"and protracted disease blood wound intruded into collateral. It has summaried that the theory and methods of discriminate and treat collateral disease fairly complete, thus developed the scholarship of the ancients well, making the theory a system firstly. And nowadays, we pay more attention to the theory of collaterals disease, making it more perfect day and day. We analyzed the pathological mechanism of collaterals and the reason why collateral disease happens, then gave clinical importance to the treatment of chronic nephropathy. Objective: Study of theory, in order to approach the form and the development of the collaterals disease, we collect and arrange the collaterals disease treatment of the doctors'during past dynasties and the present age; next we combine together the physiology and pathology of the kidney to use collateral disease theory to approach the traditional Chinese medical pathogenesis, and then manufacture the traditional Chinese medical compound recipe called"Shenluotong".Clinical study: In order to provide clinical proof which is used to treat the chronic nephrosis, we observe the protective action of the collateral disease theory which is used to the patients who are suffering the mesangial proliferative glomerulonephritis (MsPGN), and probe the protection and the correlative mechanism of the"MsPGN", We also disprove the nature of science in the composed of shenluotong to move forward a single step the value of the collaterals disease theory.Method: 1 Probing the theory: On the base of compiling and sorting the collaterals disease treatment of doctors, during past dynaties and the present age. We approach the form and the development of collaterals disease, and then integrate the clinical manifestation of the chronical nephrosis, pathological feature of the renal, and the nephrosis rapeutic effect which we use to treat the nephrosis. We also probe the etiopathogenisis and the pathogenisis of the chronic nephrosis, and point out that etiopathogenisis and the pathogenisis most likely can be seen are the deficiency of vital energy, blood stasis and rein locked. According to the methods which are benefiting vital energy and communicating vein, promoting blood flow, we formulate the traditional Chinese medical compound recipe called"Shenluotong". 2 Clinical research: Referencing the《the proposition of the MsPGN pathological type and its name》in the second nephrological meeting in September 1985, we chose 178 patients who had been made a definite diagnosis through renal needle biopsy, and divided stochastically them into treating group that is 104 people and controlling group that is 74 people, we use"Shenluotong"or tripterygium glycosides to each of them."Shengluotong"include Radix Astragali 30g,Salvia Miltrorrhiza 15g Szechwan Lovage Rhizome 10g,Zaocys 10g,Pheretima 12g,Poria 15g, capsules have been taken in the type of oral administration (4pills tid po) . We must plus or minus the medicine with the change of the patient's condition. Every course of treatment is 45 days, we observed 2 courses, control group are given tripterygium glycosides which is made in zhuzhou pharmaceutical factory in Hubei province,and direction is 1mg/kg·d, tid po. We contrast and observe in this process.According to the second nationwide conference about assessing therapeutic effect in nephrosis of traditional Chinese medicine, its standards can be divided into:1 Complete remission: symptom and signs are both vanished, the quantitation of urine protein is less than 0.2g/24h, renal function and lipid are recovery to normal, red blood cell count in urine are not so many as 0-3 /HP.2 Essentially remission: symptom and signs are both vanished, the quantitation of urine protein is less than lg/24h, red blood cell count in urine is from a little to (+).3 Partially remission: symptom and signs are improved, the experimental examination is improved, but are under the standard of essentially remission.4 Ineffective: to cure a patient more than 2 month in this method, symptom, signs and the experimental examination do not improve or the condition aggravates.Use these standards to assess the two groups of the patients'therapeutic effect.Result:The clinical study showed that kidney rutosids could improve the cardinal symptoms of MsPGN patients. There were 25(24%) patients completed remission,47(45%) patients basic remission,14(19%) patients partial remission,18(17%) patients inefficacy, 86 (83%)patients total utility in the treatment group. There were 14(13%) patients completed remission,47(45%) patients basic remission,17(23%) patients partial remission,12(16%) patients inefficacy, 43(58%) patients total utility in the control group. The total remission rate and total effect rate compared between control group with treatment group had significant difference.Specific index showed:1 Compared to the prior treatment, the 24h urine protein quantitation decreased significantly after treatment (p<0.05). Compared treatment group with post-treatment of control group, the 24h urine protein quantitation also had significant difference (p<0.05).2 Compared to prior treatment, the urine red blood cell count decreased significantly after treatment (p<0.05). Compared treatment group with post-treatment of control group, the urine red blood cell count also had significant difference (p<0.05).3 Compared to prior treatment, the urineβ2-MG decreased significantly after treatment (p<0.05). Compared treatment group with post-treatment of control group, the urineβ2-MG also had significant difference (p<0.05).4 Compared prior treatment with post treatment only the bloodβ2-MG had no-significant difference (p>0.05), there was the same result compared treatment group with post-treatment of control group (p>0.05).Conclusion:1 Use collateral theory to discuss the pathogenesis of chronic nephropathy by Chinese traditional medicine first, point out that chronic nephropathy is the consequence of kidney-Qi deficiency and collaterals lock and accumulation in final when nephropathy exist a long time, which pathology theory have internality pertinence with ECM in MsPGN and regulate mechanism. Establish the theory of benefiting vital energy with dredge collaterals and activating blood circulation to dissipate blood stasis, and to formulate schema on these ground will bring new ideas.2"Shenluotong"has efficacy of benefiting vital energy with dredge collaterals and activating blood circulation to dissipate blood stasis, is an available medicine to treat mesangial proliferative glomerulonephritis. This research has confirmed that ShenLuoTong has the ability of degrade Urine protein and urin-akaryocyte and urin-β2-MG, more over, it can protect the renal function.